A Cross-sectional Study on the Challenges Faced by Postgraduate Students While Conducting Dissertations in Medical Institutes of India

Introduction

Research is one of the fundamental and primary processes of development for all advanced nations. The three leading countries such as the USA, China, and Japan have identified research and experimentation as the most supreme key factor for their overall evolution.¹

The primary objective of research is to encourage innovation and ensure sustainable social economic development.² Research exposure is critical for physician's evidence based practice, as it imparts skills such as literature searching, collection and assessment, and analytical evaluation of evidence.³ The propagation of research and expansion of the knowledge base in health sciences are important for patient care and formulation of health policies.^4,5 Evidence suggests that participation in research projects during medical education leads to greater postgraduate research involvement in professional careers.^6,7 Guidance in research activities and early exposure to research have been associated with continued professional academic work and may assist postgraduate residents in their future career decisions.⁸

At present, Western countries are far ahead in their research activities, whereas limited research output is observed in Asian and Middle Eastern countries. India’s low ranking of 40 in the Global Innovation Index reflects a prevailing feudal culture in science education and research, which inhibits questioning and out-of-the box thinking.⁹ Exposing students to a research oriented environment in medical schools will help cultivate research mindset among young doctors.¹⁰

Considering this background, the medical academic authorities in India have made dissertation, thesis, research work mandatory for eligibility to appear in the MD/MS postgraduate and MCh/DM super-specialty medical examinations. In addition, to inculcate research oriented behaviour among medical students, the National Medical Commission (NMC) has made it compulsory for postgraduate students to attend at least one international or national conference and to present at least one poster or paper at a national or state-level conference during their training.¹¹ Thesis or dissertation proposals must be prepared in a meticulous and organized manner so that the student's understanding, expertise, attitude, and principles are clearly reflected in their research work.¹²

During residency, while pursuing postgraduate medical courses, students are supported by academic resources and infrastructure and are expected to undertake independent research projects under the guidance of their postgraduate teacher or guide. Support systems designed to improve research knowledge during postgraduate training include research methodology workshops, good clinical practice workshops, the basic course in biomedical research, research supervision or mentorship by senior academicians and statisticians. However, there are high expectations during residency training regarding patient workload, academic performance, and professional commitment. Postgraduate residents often find it challenging to balance personal life, clinical responsibilities, academic advancement, and research activities.

By and large, mostly postgraduate students consider dissertation as a daunting task due to challenges such as topic selection, literature review, research design, and the actual conduct of the study.¹³ Research work is also likely to be influenced by various personal and professional obstacles. Furthermore, student's support services, particularly effective supervision, represent an other crucial factor that needs to be addressed.

Good supervision plays a key role in ensuring authentic postgraduate research; however, it remains a widely misinterpreted teaching-learning process.¹⁴ Several studies have discussed various factors that limit the success of postgraduate research work. Such studies have reported that many postgraduate students either drop out or fail to complete their research work within the stipulated time.^15,16

The present study was undertaken to identify the factors responsible for the disinterest or failure to complete research work among postgraduate resident students in medical institutes.

Aim

To identify and analyze the various academic, institutional, and personal challenges faced by postgraduate (PG) medical students during the process of conducting their dissertations in medical institutes across India.

Objectives

1. To assess the common difficulties faced by PG students at different stages of dissertation work - including topic selection, proposal writing, data collection, statistical analysis, and thesis submission.

2. To evaluate the role of institutional support, faculty guidance, and availability of research resources in influencing the progress of dissertation work.

3. To explore the extent of research training, knowledge of research methodology, and awareness of ethical considerations among PG students.

4. To identify the psychological and time-management challenges encountered during the dissertation process.

5. To propose strategies and interventions to overcome the identified challenges and improve the quality and feasibility of postgraduate research in medical education.

Materials and Methods

The study was conducted at postgraduate medical institutions and employed a cross-sectional descriptive design. A total of 226 postgraduate students participated in the study. A validated questionnaire was developed to collect detailed information regarding the challenges faced by students during the completion of their dissertation work. The questionnaire was administrated through a Google Form and distributed among second and third year postgraduate students, ensuring anonymity.

Inclusion Criteria

Second and third year junior residents (postgraduate students) who had completed and submitted their synopsis to the university and had begun data collection and dissertation writing.

Exclusion Criteria

First year junior residents (postgraduate students) who had not yet submitted their synopsis to the university.

A validated Google Form was circulated over a period of one month. The questionnaire included demographic details of the participants, stress factors related to thesis completion, and other relevant information. Participation in the survey was entirely computerized, anonymous, and voluntary. Data were compiled and analyzed using MS Excel, and statistical analysis was performed using descriptive statistics, primarily expressed as percentages.

Results

A total of 226 postgraduate medical students who were in the process of completing their dissertation work were surveyed using a structured questionnaire, and the following information was obtained.

Socio-Demographic Variables

Age of the participants

The majority of participants (n=110) were in the 26-30 years age group. Older participants aged 36-40 years (n=02) were in-service postgraduate students. About 38.05% of participants (n=86) belonged to the 20-25 years age group, while 12.38% (n=28) were in the 31-35 years age group.

Gender distribution

An almost equal gender distribution was observed, with 47.78% of participants being male (n=108) and 52.21% female (n=118).

Place of schooling

Of the total study population, 39% (n=88) came from metropolitan cities, 35% (n=79) from district areas, 19.91% from towns (n=45), and 6% (n=14) from state capitals.

Language of basic schooling

Among the participants, 42.47% (n=96) had vernacular (regional) languages as their medium of instruction, 37.16% (n=84) studied in English medium schools, and 20.35% (n=46) came from convent-school backgrounds.

Undergraduate institutes

A majority of participants 61% (n=137) completed their undergraduate medical education from government medical colleges, 32% (n=72) graduated from private medical colleges, and 7.52% (n=17) from autonomous institutes.

Parents or close relative as medical practitioners

More than half of the participants 56%, (n=126) had no medical background in their family, whereas 35% (n=80) had a close relative in the medical profession, and nearly 9% (n=20) reported having a distant relative in the field.

Challenges Faced by Postgraduate Students

Dissertation topic selection

As shown in Figure 1, 55% of postgraduate students reported that their dissertation topic was assigned or influenced by their postgraduate guide or teacher. In contrast, 35% of the participants were uncertain about the same.

Knowledge levels while selecting the dissertation topic

Figure 2 illustrates that 85% of postgraduate students had introductory knowledge of their thesis topic at the time of selection. However, nearly 51% (n=99) of these students expressed a desire to change their dissertation topic.

Support from the guide

A majority of participants 81% (n=182) reported receiving substantial support from their guide/supervisor during their thesis work. In contrast, 17% (n=38) expressed dissatisfaction with the guidance received, while six participants (2.63%) stated that they received no support from their guide.

Support from the department

Similarly, 72% of the respondents (n=162) acknowledged adequate assistance from their respective departments. However, 23% (n=52) expressed dissatisfaction, and 5% (n=12) reported a lack of departmental support for their dissertation work.

Support from the institute

Institutional assistance was also rated positively, with 80% of participants (n=180) confirming wholehearted support from their institutes. Meanwhile, 19% (n=42) were uncertain about the level of institutional support, and 4 participants (1.76%) reported receiving no support from their institute.

Financial concerns during dissertation

A majority of postgraduate students 73% (n=164) reported facing no financial concerns during their dissertation work, whereas 18% (n=40) experienced financial difficulties in managing research-related expenses.

Ideal time for selecting and starting the dissertation

According to most participants 57%, (n=128), the ideal time to initiate thesis work is during the second year of postgraduate training, while 43% (n=98) considered the first year to be more appropriate for thesis initiation.

Ideal duration for dissertation work

Nearly 45% (n=103) of participants considered 18 months to be the ideal duration for completing dissertation work. In comparison, 34% (n=76) preferred a 12-month period, and 21% (n=47) suggested that 24 months would be optimal.

Neglect of clinical/departmental work during dissertation

Most students 76%, (n=171) reported that their research activities did not interfere with clinical/departmental duties. However, 8% (n=18) acknowledged some degree of negligence in clinical work, while 16% (n=37) were not sure.

As shown in Table 1, 62% of the study population reported difficulties in understanding research methodology while designing their dissertation, whereas 12% experienced challenges with both study design and research methodology.

Table 2 shows that 19% of the study participants reported experiencing a feeling of helplessness during their thesis work, while 33% stated that they experienced it occasionally.

As shown in Table 3, statistical analysis was identified as the most stressful factor in the dissertation process, particularly in terms of understanding and application of statistics, as reported by approximately 30% of the study population.

Discussion

Research is an analytical tool that provides factual evidence to strengthen the answers to scientific questions. It contributes to the expansion of knowledge, theories, and concepts. Challenges refer to the hurdles that test a researcher’s ability to obtain accurate findings and serve as opportunities to realize their full potential in conducting research. The present study involved 226 postgraduate students from medical institutes who voluntarily participated to report the challenges faced while carrying out their dissertation work.

Based on the socio-demographic variables, it was observed that the majority of students belonged to the 26-30 years age group. A similar finding was reported in a study by Giri PA et al., (2014), where most postgraduate students were in the 26-28 years age category.¹⁷ However, while their study showed a male predominance (59%), the present study demonstrated no such gender predominance, with 47% male and 52% female participants.

The place and language of basic schooling play a pivotal role in dissertation writing, as they contribute to an individual’s vocabulary development and thesis drafting skills. In the current study, 39% of participants belonged to metropolitan cities, while a comparable proportion (35%) came from district areas. Students from metropolitan cities and district regions are generally more technologically adept and have greater access to academic literature compared to those from smaller towns. Regarding the medium of schooling, 42% of postgraduate students had vernacular (regional) language instruction and 37% were educated in English medium schools, and 20% had attended convent schools. The language of schooling thus emerges as a key factor influencing the quality of manuscript composition.

Undergraduate institutes form the foundation for learning, experience, research work, and the overall professional development of postgraduate students. Those graduating from government institutions are typically exposed to a higher volume of clinical work and research activities, which helps them develop a basic understanding of innovation and research analysis. Similar findings were reported by Segal et al., (1990).¹⁸ In the present study, 61% of participants completed their undergraduate education at government institutes, 32% at private institutes, and 7% at autonomous universities.

Research activity is also likely to be assisted by close family members who belong to the medical field. Having a close relative with a medical background can help postgraduate students better understand and interpret their thesis topic, and formulate appropriate research question. In the present study, more than half of the postgraduate students (56%) reported having no family background in medicine.

The major challenges identified were related to the actual conduct of the thesis, beginning with the selection of the dissertation topic. Nearly 56% of postgraduate students reported that their thesis topic was influenced or decided by their postgraduate guide or teacher, while 35% were uncertain about the same. The influence of supervisors on topic selection has also been documented in a study by Antoinette McCallin et al.¹⁹ Furthermore, 85% of students stated that they had a preliminary understanding of their thesis topic at the time of selection; however, almost 51% expressed a desire to change their topic. Similar findings were reported by Golde et al., and Chireshe et al., where approximately 40% of students indicated a wish to change their research topic.^20,21

Research activities require continuous supervision and support from senior faculty members. Anderson, Day, and McLaughlin, as well as Hockey, have emphasized that supervisors play a crucial role toward the successful completion of their thesis.^22,23 This was evident in the present study, where 81% of students confirmed.

receiving adequate support from their postgraduate supervisors. Additionally, 72% students reported assistance from their respective departments, and 80% acknowledged that their institutions were supportive in facilitating synopsis approval and university clearance. Financial concerns were raised by approximately 17% of PG students in the present study, compared to 37% reported in the study by Giri PA et al.¹⁷

In the present study, 57% of students considered the second year of postgraduate training to be the appropriate time to initiate research activities. This can be explained by the fact that, by this stage, students have acquired a foundational understanding of their speciality and are better positioned to decide on their dissertation topic and study design. Additionally, 45% of students reported that an 18-month duration would be ideal for completing dissertation work, as it allows sufficient time to balance clinical responsibilities and academic commitments.

In the present study, 75% of students reported that their dissertation work did not interfere with their clinical or departmental duties. This finding is comparable to that of a study conducted by Stebbing J et al., in which 71% of students stated that their research activity did not affect their professional work or status.²⁴

Any research proposal requires appropriate study design, sound methodology, and accurate statistical analysis. A study conducted by Leila Bazrafkan (2016) reported that students experienced considerable difficulty in designing their dissertations, a finding consistent with the present study, where nearly 25% of postgraduate students reported similar challenges. Research methodology education had not been included in the postgraduate curriculum until recent years, which may explain why 62% of students in the current study found research methodology difficult to comprehend. Comparable results were observed in studies by Leila Bazrafkan, and Barry KM et al.^25,26 Furthermore, Giri PA et al. reported that nearly 71% expressed a willing-ness to participate in research methodology workshops to better understand basic concepts.¹⁷ In the present study, approximately 12% of postgraduate students experienced difficulty in understanding both study design and research methodology.

Approximately 19% of postgraduate students reported experiencing a sense of “helplessness” doing their dissertation work, while 33% reported experiencing this feeling intermittently. Poor understanding of research process, such as topic selection, study design, research methodology, data collection, and the need for timely supervision, plays a critical role. As PG students encounter difficulties in these areas at various stages, they may feel overwhelmed and find it difficult to cope.

Stressful factors associated with dissertation work, with 30% of students reporting that understanding and applying statistical analysis the most stressful component. Similar observations were reported in several other studies.^26-28 Giri PA et al. also noted that postgraduate students were interested in learning statistical analysis, as it would enhance their ability to better understand their research findings.¹⁷

The current study highlights the various challenges and stressful factors encountered by postgraduate students during conduct of their research activities. Completing a dissertation in a systematic and stress-free manner requires suitable circumstances across multiple domains and a sense of responsibility from both students and supervisors. Effective communication with trainers and other relevant mentors is crucial for helping students cope with stress and anxiety. Some of the recommendations that may help alleviate these challenges are:

1. Introduction of research training earlier in the medical career, rather than initiating directly at the postgraduate level.

2. More frequent inclusion of research methodology and good clinical practice workshops in the postgraduate curriculum throughout the training period.

3. Periodic dissertation reviews to ensure continuous progress and maintain students’ interest in their research work.

4. A more approachable and supportive supervisor-student relation, enabling easier access to teachers/ trainers.

5. Timely feedback from supervisors on research work to facilitate progress and prevent delays.

The implications of this study include the effective use of an online forum to identify the difficulties faced by post-graduate medical students during their dissertation work. However, several limitations should be acknowledged. The study included a limited number of postgraduate students, a larger study population would be necessary for generalizability of the outcomes and findings. The present study results should be considered exploratory and serve as a foundation for future large scale research.

Conclusion

The study outlined various factors contributing to the lack of interest among postgraduate students in completing their dissertation work, largely due to the enormous challenges they encounter. Although recent NMC guidelines have brought about notable changes, much of the research training continues to follow traditional approaches. There is a pressing need to encourage postgraduate students to undertake research projects by providing technical support and essential infrastructure throughout their training.

Conflict of Interest

Nil